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Claims associate vs claims clerk

The differences between claims associates and claims clerks can be seen in a few details. Each job has different responsibilities and duties. It typically takes 2-4 years to become both a claims associate and a claims clerk. Additionally, a claims associate has an average salary of $36,558, which is higher than the $32,815 average annual salary of a claims clerk.

The top three skills for a claims associate include customer service, medical claims and phone calls. The most important skills for a claims clerk are data entry, customer service, and clerical support.

Claims associate vs claims clerk overview

Claims AssociateClaims Clerk
Yearly salary$36,558$32,815
Hourly rate$17.58$15.78
Growth rate-3%-3%
Number of jobs9,14578,588
Job satisfaction--
Most common degreeBachelor's Degree, 48%Bachelor's Degree, 31%
Average age4444
Years of experience44

What does a claims associate do?

Claims associates control claims for insurance companies. Their job duties include determining a customer's insurance coverage and evaluating those who have filed a claim. Also, they must make sure that a claim is analyzed correctly for the clients to receive their entitled financial settlement. The work may require the agent to travel to generate information about the claim and may vary from a different position in the insurance industry. Qualifications for the job include an associate degree, excellent interpersonal and research skills as well as relevant experience in customer service.

What does a claims clerk do?

Claims clerks review the forms and documents for insurance claims to check for missing information and attachments. The data they obtain is entered into their database for safekeeping and quick retrieval. They should know the answers to their clients' questions about the regulations, policies, and procedures covered by their insurance policy. These clerks prepare documents that their agents use to present to their clients. When working for this position, a person must have the ability to communicate well and be familiar with computer applications.

Claims associate vs claims clerk salary

Claims associates and claims clerks have different pay scales, as shown below.

Claims AssociateClaims Clerk
Average salary$36,558$32,815
Salary rangeBetween $30,000 And $44,000Between $27,000 And $39,000
Highest paying CityHartford, CT-
Highest paying stateConnecticut-
Best paying companyAccenture-
Best paying industryInsurance-

Differences between claims associate and claims clerk education

There are a few differences between a claims associate and a claims clerk in terms of educational background:

Claims AssociateClaims Clerk
Most common degreeBachelor's Degree, 48%Bachelor's Degree, 31%
Most common majorBusinessBusiness
Most common college--

Claims associate vs claims clerk demographics

Here are the differences between claims associates' and claims clerks' demographics:

Claims AssociateClaims Clerk
Average age4444
Gender ratioMale, 30.3% Female, 69.7%Male, 17.5% Female, 82.5%
Race ratioBlack or African American, 13.8% Unknown, 4.3% Hispanic or Latino, 14.4% Asian, 3.9% White, 63.2% American Indian and Alaska Native, 0.5%Black or African American, 13.8% Unknown, 4.3% Hispanic or Latino, 14.4% Asian, 3.9% White, 63.2% American Indian and Alaska Native, 0.5%
LGBT Percentage11%11%

Differences between claims associate and claims clerk duties and responsibilities

Claims associate example responsibilities.

  • Investigate, evaluate, and manage call to complete coverage analysis confirming or denying coverage using Xactimate estimating software.
  • Obtain vehicle information from the DMV.
  • Follow HIPAA policy on each and every call.
  • Abided by the laws and regulations associate under HIPAA and patient confidentiality.
  • Receive recognition for creating a workflow and database for all incoming subpoenas.
  • Assist in training new CSA s on job responsibilities, which increase office productivity.
    • Show more

Claims clerk example responsibilities.

  • Manage adding and removing vendors through claims automate system to ensure they are in compliance with IRS regulations.
  • File commercial, worker's comp, Medicare, and Medicaid claims to insurance carriers and employers.
  • Open and sort mail by claim types (HCPA UB 92 and T18).
  • Process medical HMO claims, POS claims, PPO claims and fee for service claims.
  • Review, scan, and file HCFA forms
  • Audit paper claims for accuracy in CPT and ICD9 codes.
    • Show more

Claims associate vs claims clerk skills

Common claims associate skills
  • Customer Service, 14%
  • Medical Claims, 8%
  • Phone Calls, 8%
  • Claims Handling, 7%
  • Insurance Claims, 6%
  • Medical Terminology, 5%
Common claims clerk skills
  • Data Entry, 26%
  • Customer Service, 9%
  • Clerical Support, 7%
  • Computer System, 5%
  • Medical Claims, 4%
  • Process Claims, 4%

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Updated January 8, 2025

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